Thoracic Vertebrae

• There are twelve vertebrae (T1-T12) all of which

articulate with ribs
• Major markings include two facets and two
demifacets on the heart-shaped body, the circular
vertebral foramen, transverse processes, and a
long spinous process
• The location of the articulate facets prevent flexion
and extension, but allow rotation of this area of the
spine
Thoracic Vertebrae

Figure 7.17b
Vessels and nerves of the face:
Part of the head and neck file.

Dr. Samsam
Pictures from: Platzer atlas and textbook of human anatomy
Big vessels in the neck:

internal Jugular V.

Superior cervical Hypoglossal nerve

sympathetic ganglion
External Carotid A.
internal Jugular V.
Common
Carotid A.
Common facial V.

internal Jugular V.
Brachial plexus
Vagus N.
Subclavian A.
Anterior Facial Regions:
First of all, the blood supply of the face is
mostly by ext. carotid and partly by int. carotid.
Facial artery (2) from ext. carotid passes
it anastomose with dorsal nasal A. (4) coming
from Ophthalmic A.
Forehead is supplied by supratrochlear A. (8)
and supraorbital (9) A., both from ophthalmic A.

Facial vein (10) anastomoses via Angular

vein (11) With dorsal nasal vein.
***This anastomoses is extremely important
since this allows a direct connection to
Cavernous sinus, through which, infections
eg: from a furuncle on the lip, may get into skull.

All mimetic muscles are innervated by branches

of facial N: 13- temporal branch, 14- zygomatic
15- buccal branch and 16- marginal mandibular.
Anterior Facial Regions:
Sensory innervation to the face:
Is derived from branches of
Trigeminal (V) nerve: Ophthalmic (V/1),
Maxillary (V/2) and mandibular (V/3) nerves.
Ophthalmic nerve: supplies the forehead:
Supratrochlear N (17) and supraorbital (18).
Maxillary nerve: supplies lower eyelid,
Cheek, lateral nasal, upper lip and anterior
Temporal regions by Infraorbital N. (22).
Mandibular N: lower lip over mandible
(not angle) and chin by mental N (23).
Auriculotemporal N (24) supplies skin on
Mandible ramus, concha of auricle and
Most part of ext. layer of tympanic memb.
Sensitivity of the 3 branches of trigeminal N
can be tested by pressing nerves 18, 22 and 23.
This is a vertical line, 2-3 cm lateral to midline.

***Trigeminal Neuralgia.
 Trigeminal neuralgia (Tic Douloureux)

A disorder of unknown etiology (cause) associated with intractable pain along the 3
branches of trigeminal nerve but especially along maxillary and mandibular
nerves. A simple trigger such as touch, cold or hot can start the pain.

Therapy: Carbamazepine, radiofrequency destruction of the

branches involved.
Alcohol or Glycerin injection around the trigeminal ganglion.
Transection of the sensory root.
Vascular decompression of the trigeminal ganglion.